Related Experiment Videos
Benefit of the steroid electrode
M Kriwisky1, J Goldstein, M S Gotsman
1Department of Cardiology, Hadassah University Hospital, Jerusalem, Israel.
Chest
|December 1, 1987
Summary
A novel steroid-eluting pacemaker electrode successfully treated a patient with complete heart block and recurrent exit block. This advanced lead offers a potential solution for patients experiencing progressive threshold increases after multiple electrode implantations.
Area of Science:
- Cardiology
- Biomedical Engineering
- Medical Device Technology
Background:
- Complete heart block necessitates permanent pacemaker implantation for survival.
- Recurrent exit block and rising pacing thresholds pose significant challenges in pacemaker management.
- Previous electrode revisions (five endocardial, one epicardial) failed to resolve the patient's pacing issues.
Observation:
- An 80-year-old patient presented with complete heart block requiring permanent pacemaker implantation.
- The patient experienced progressive increases in pacing threshold, leading to recurrent exit block and multiple electrode failures.
- Six electrode revisions were performed without achieving stable pacing parameters.
Findings:
- A porous, steroid-eluting endocardial electrode was implanted as a final attempt.
- This specialized electrode provided 27 months of excellent and stable pacing service.
- The steroid elution likely mitigated the inflammatory response contributing to threshold rise.
Implications:
- Steroid-eluting electrodes may be a superior option for patients with high pacing thresholds or exit block.
- This technology could reduce the need for repeated pacemaker lead revisions.
- Further research is warranted to evaluate the long-term efficacy of steroid-eluting leads in challenging pacing cases.